Nipple Care for the Pumping Momma

Take care of those nips, mommas! To effectively treat nipples that have become injured from breast pumping, you have to figure out what’s causing the pain in order to prevent further damage. Let’s heal those hurting nipples and problem solve together so it doesn’t happen again!

A bit of soreness or sensitivity, especially at the beginning of your pumping session/journey, is normal. PAIN is not normal. And don’t let someone tell you “Oh you just get used to it.” If you’re experiencing pain with pumping, which has resulted in an injured nipple… there’s probably something causing that injury, NOT just the fact that you are pumping in general.

Possible causes for nipple injury:

• 😖Incorrectly sized flange- Your nipple should pulse freely within the flange tunnel without rubbing the sides or pulling too much of your areola into the tunnel. For more on flange sizing, revisit my blog post about it HERE.
• 😖Poor latch- Nursing mothers who think latch may be a contributing factor to their pain should make an appointment to get baby’s latch assessed by a lactation consultant. See if your insurance covers lactation appointments!
• 😖Abrasion- Rubbing can cause the nipple/areola to become saw and sensitive. I suggest using a small dab of coconut oil on areola before pumping for lubrication. I do not suggest using nipple balm/butter, as it is too thick for lubrication.
• 😖Pump suction is too high- Higher suction does NOT equal more milk! Turn that dial down for comfort. Pump at a strong but comfortable suction level.
• 😖Mastitis- Flue-like symptoms, redness, and pain. These infections need to be treated by a doctor. Rest, ice, and anti-inflammatory medication may be prescribed.
• 😖Thrush- Yeast can really hurt and itch. Mommas often report random shooting pain in the core of their breast. Change nursing pads frequently and keep them dry! Talk to your doctor if you think you may have thrush.
• 😖Elastic nipple tissue- If your nipple swells and stretches to fill the entire flange tunnel no matter what size flange, you might need a specialty flange like pumpin pals or beaugen cushions. I suggest setting up a consultation or flange sizing!

How do you treat injured nipples?

• 😅Air nipples- When possible, go shirt/braless for 5-10 minutes to air out your nipples.
• 😅Moist wound healing techniques (see below)- Wet/moist wound healing often works better for nipples because they constantly get wet.
• 😅Warm saltwater/normal saline soak- Use an unscented Epsom salt in warm water. Do not use a Hakkaa suction pump. Many mommas dangle the breast into a bowl of water.
• 😅Allow breastmilk to sit onto nipples- Your own breastmilk has wonderful healing properties! Dab some on, or wet a small cloth with your breastmilk and lay on nipples.
• 😅Avoid soaps- Your montgomery glands self-clean your nipples. Avoid washing nipples directly with soap in the shower.
• 😅Natural nipple ointment- I like Mother Love or Earth Mama! Consider staying away from anything containing Lanolin, as some women are allergic to this wool derivative.
• 😅Silverette cups or Medela shells– Silverettes have natural healing properties and Medela softshells provide a nice barrier to allow nipples to heal.

What is “wet wound healing?”

💧 Usually what we think of when we think of healing cracked skin is DRY wound healing- airing the injury to form a scab. (This works well on your arms/legs/etc) HOWEVER, wet/moist wound healing works better for nipples because they constantly get wet. If that scab gets repeatedly wet and pulled off, healing can take forever.
💧 Instead, consider practicing WET wound healing for cracked nipples!
Apply a dab of breastmilk on the nipples. Consider a barrier that allows the nipple space to heal, like using Medela soft shells or Silverettes. Use a natural nipple butter after pumping for healing. A doctor may prescribe an all-purpose nipple ointment (commonly called APNO cream).
💧 Make sure you are applying a lubricant before pumping (food-grade coconut oil works well) to avoid further abrasion. Use the lowest suction allowable while still removing milk, and some light compressions to the breast to allow for full emptying. In extreme cases, hand-expression may be necessary until cracks heal.
AVOID soaps. Change breast pads frequently.

⚠️*The key is figuring out WHY nipples are becoming damaged- flange size? Strong suction? Poor latch?

⚠️You should speak to your health visitor or GP if you have signs of infection (like abnormal swelling, inflammation, discharge, fever and/or chills, or feeling ill), or if your wound doesn’t heal after a few weeks.

PAIN is not normal during nursing or pumping. Pain is not something you’ll just get used to. Your nipples will not get calloused or toughened up. If you are experiencing pain, it’s a sign that you may benefit from a latch assessment or flange sizing with a lactation professional.
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When you first begin breastfeeding, you and your baby are learning together. They might not automatically form a good, comfortable latch. Watching videos on good latch will help you know what a good latch looks like, but working with a lactation consultant as soon as possible will 100% help getting baby into and out of a latch and avoid damaging your nipples.
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Breast pumping should not hurt either. Yes it might be slightly uncomfortable. Some women do experience briefly painful letdown. With a correct flange size, lubricant if you need it, and suction that is high yet comfortable, pumping can be pain-free.

Other types of pain you might experience-

• 😖Engorgement as your mature milk comes in- Use ice packs and make sure you are remove that milk regularly and frequently! Do “reverse pressure softening” before nursing or pumping.
• 😖Clogged ducts- Check my “Pain” highlight on Instagram for my best tips for unclogging clogs as soon as possible so it doesn’t turn into mastitis.
• 😖Mastitis- Usually comes with a fever and flu-like aches and fatigue. Can be a red and painful breast. Contact your doctor for treatment!
• 😖Thrush- Yeast infection of the breast- needle/lightning like pain in the core of your breast, can be white patches in baby’s mouth- see your doctor or a lactation professional for treatment
• 😖Vasospasm- nipple turns white and extremely painful when you unlatch or take the flange off- applying immediate warmth will help. Look up this term for more info.
• 😖Nausea during letdown- The sudden rush of oxytocin during letdown causes smooth muscle contraction which can make you feel nauseous or need to use the bathroom. Sip ice water or suck on ginger or peppermint lozenge.
• 😖DMER- Extreme feelings of rage, anger, anxiety, depression, during letdown that passes quickly. Look up this term for more info.